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many people report a fluctuation in their symptoms. If so you are lucky because at least you have quiet days.
Presumably there are those that dont get fluctuations? is it true? How can this difference be explained?

I don't think "tinnitus" is by any means a singular condition, I think it's a set of different symptoms with the common characteristic "unwanted noise in head not caused by external sounds". I have a lot of theories about why my tinnitus fluctuates; it's hard not to because I'm pretty aware of at least some of the variables. But, I would not try to apply any of these theories to other people.

For instance, in addition to my tinnitus, I have similar and almost certainly related visual issues. That's definitely not true of all tinnitus patients, and it may not be true for most of them.

Not sure about fluctuating tinnitus, but I do get spikes... Two triggers that I'm aware of are stress and chocolate.

Whether we see the greatest value in wisdom or in action, in neither case may we scorn science. It alone shows us the way both to knowledge and to action. Without it our existence would be only vegetative. - Ludwig von Mises

Its funny how we cant go deaf from tinnitus. Persistent loud noise exposure can cause hearing loss. Tinnitus can be pretty loud.

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Noise itself does not cause auditory damage; rather it is the sound waves that result in the noise that cause the damage. Tinnitus does not originate as a sound wave. Thus you can't go deaf from tinnitus. Tinnitus can make you pretty damned miserable, but it cannot make you deaf.

well i actually read somewhere that it is noise rather than the soundwaves which causes damage.

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Have you ever done a physics experiment in school (as a demonstration) where an alarm clock like this...

...is placed inside a see-through glass container with the air inside gradually being vacuumed? If you have, you will know the similarity between noise and sound waves (i.e. you can't have one without the other from the point-of-view of the perceiver, and assuming the perceiver is not deaf...). The reason an old fashioned alarm clock is chosen is because it makes visible to the audience that it is still ringing while in the container.

And to be perfectly accurate: noise is a perception (not a physical entity); the converse applies for sound waves. And so it is the sound waves that do the damage. Without a perceiver there would just a sound wave, but no noise!

All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.‒ Arthur Schopenhauer

"NIHL (Noise Induced Hearing Loss) is therefore the consequence of overstimulation of the hair cells and supporting structures."​

But this overstimulation they are referring to is not the result of noise - it is the result of the sound waves that are converted to electrochemical signals by the hair cells that act as tiny transducers. There is no noise per se until the electrochemical signals make their way into the brain where they are ultimately perceived as noise. The term NIHL is actually a misnomer - but if they called it SWIHL, that would result in even more confusion ... because when John Q. Public attends a sporting event with a huge screaming crowd, as far as he is concerned the crowd is making noise and not sound waves. And when the announcer foolishly wants to get the crowd yelling and screaming at the 120dB level, he doesn't tell them to make some sound waves; he tells them to MAKE SOME NOISE!!!

Indeed the dB meter itself isn't measuring noise. Rather, it is reflecting the amplitude of the sound waves that will ultimately become noise in the brain!

the point i was trying to make, is that i used to think hearing loss occurs because the sound is so intense that the force of it literally strikes the hair cells and/or ossicles and destroys it in that way. However it seems this is not really what happens. The way damage seems to occur is as a secondary process as described in that wikipedia link. which would explain why NAC would work in some cases.

Now if its not only the force that causes damage then I wondered whether tinnitus could trigger further hearing loss in the same way soundwaves do

the point i was trying to make, is that i used to think hearing loss occurs because the sound is so intense that the force of it literally strikes the hair cells and/or ossicles and destroys it in that way. However it seems this is not really what happens. The way damage seems to occur is as a secondary process as described in that wikipedia link. which would explain why NAC would work in some cases.

Now if its not only the force that causes damage then I wondered whether tinnitus could trigger further hearing loss in the same way soundwaves do

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This is what happens in the case of extreme sound pressure levels. At 120dB you can be pretty sure that actual physical structures in the inner ear will take damage. At least the hair cells will "blow up" at most of the frequencies more or less.

Now if its not only the force that causes damage then I wondered whether tinnitus could trigger further hearing loss in the same way soundwaves do

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the longitudinal data I have seen does not support this idea. Additionally, when you consider that most people who find T bothersome end up taking steps to protect their hearing that healthy people do it, it seems reasonable that having tinnitus from a younger age might actually be correlated with having better hearing later in life.

When I was completely deaf, and I did tell them I cannot hear anything but the T noise, they did a hearing test up to 120db. Now I believe they caused more damage.

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Hi, sorry I wasn't specific enough. I was talking about more "long term" exposure. Couple or minutes or longer. Hearing test beeps are so short that they shouldn't deal damage at 120dB but it is possible in my non professional opinion. I haven't heard that any hearing tests are done such a loud volume. Usually they limit it up to 100dB or so...

When I was completely deaf, and I did tell them I cannot hear anything but the T noise, they did a hearing test up to 120db. Now I believe they caused more damage.

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that reminds me of what happened to me. They were trying to see how much noise i could tolerate so they played a series of tones at increasing volume. Even though i told them not to play too loud they ended up playing a loud tone which i found unpleasant. i see no point in that test.